Provider Demographics
NPI:1720397870
Name:SLEEPY HOLLOW DENTAL, P.L.L.C.
Entity Type:Organization
Organization Name:SLEEPY HOLLOW DENTAL, P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:YEN
Authorized Official - Middle Name:VAN
Authorized Official - Last Name:LE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:703-534-6226
Mailing Address - Street 1:2946 SLEEPY HOLLOW RD STE 1B
Mailing Address - Street 2:7 CORNERS MEDICAL ARTS BUILDING
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22044-2003
Mailing Address - Country:US
Mailing Address - Phone:703-534-6226
Mailing Address - Fax:703-534-6228
Practice Address - Street 1:2946 SLEEPY HOLLOW RD STE 1B
Practice Address - Street 2:7 CORNERS MEDICAL ARTS BUILDING
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22044-2003
Practice Address - Country:US
Practice Address - Phone:703-534-6226
Practice Address - Fax:703-534-6228
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-06
Last Update Date:2010-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty